Medicaid Plan, Visiting Nurse System Extend ArchCare’s Service in Community

By MARY ANN POUST

With a newly launched Medicaid managed long-term care plan and its acquisition late last year of the Visiting Nurse Regional Health Care System, the archdiocesan ArchCare health network continues its expansion into home- and community-based services that allow the elderly and the disabled to remain independent.

The transformation from a solely institution-based system to a more diverse array of services offered in homes and in the community began two years ago at the direction of the ArchCare board.

“It was driven by consumer preferences and by (changing) state and federal policies,” said Scott La Rue, ArchCare’s president and CEO.

He said the support of Cardinal Dolan and his predecessor, Cardinal Egan, in pushing for changes was also instrumental in allowing ArchCare to position itself to succeed in a changing health care environment.

“We had one foot in the door,” La Rue said.

The latest moves—the Medicaid managed care plan and sponsorship of the Visiting Nurse system—follow the establishment in recent years of all-inclusive care plans for the elderly known as PACE programs and a Medicare Advantage managed care plan.

Two PACE plans are already operating, one in East Harlem and one at St. Vincent de Paul Residence in the South Bronx, and a third one is under construction at the Carmel Richmond Healthcare and Rehabilitation Center on Staten Island.

Most of the funding for this major transformation of ArchCare’s ministry from institution-based to community-based will come from the sale of its Kateri Residence in Manhattan and also of St. Teresa’s Nursing and Rehabilitation Center in Middletown. Both will continue to operate as nursing homes under their new owners, La Rue said.

The new Medicaid managed long-term care plan, called ArchCare Community Life, got its final state approval in November to operate in Manhattan, the Bronx, Staten Island and Westchester, and expects to be approved shortly for expansion to Brooklyn and Queens and Putnam County. Next are Rockland and Orange counties, with approval expected in June, with the three counties in the northern part of the archdiocese to be added later.

“Our goal is to expand to all counties of the archdiocese, which will allow us to provide health care services in areas where the archdiocese has never provided them directly before,” La Rue said.

ArchCare Community Life is one of only 28 such plans operating in the state, which requires all Medicaid recipients to enroll in a plan if they receive more than 120 days of home- or community-based services per year.

The plan’s first enrollees, who came on board in November, were 107 Maryknoll Sisters in Ossining. They were already in ArchCare’s Medicare Advantage plan and are now in both programs.

Under the plan, ArchCare Community Life coordinates the benefits to its enrollees including provision of health care aides, personal care attendants, speech and other therapies, meals, transportation to appointments and other home services. The plan also is responsible for a care plan that coordinates medical services, hospital and nursing home admissions and transitions back home.

In many cases, persons enrolling in ArchCare Community Life are already receiving home care services through Medicaid and may very well continue with the same home aides and other providers that they already have.

“A lot of what we’re trying to do is to not disrupt the care they’re receiving, from the people they’re receiving it from,” La Rue said. “We’re very committed to providing continuity of care.”

The difference, however, is that ArchCare will coordinate and pay for the services under a program in which the state pays a specific amount for each Medicaid patient enrolled rather than paying for individual services. The expectation is that it encourages efficiencies and is less expensive.

By taking over sponsorship of the Visiting Nurse system, one of the oldest and most respected home-care agencies in New York’s five boroughs and Westchester, ArchCare has been able to greatly expand its home-care capabilities and the population that it serves.

The Visiting Nurse program got its start in Brooklyn in the aftermath of the great blizzard of 1888, when it began sending nurses to the homes of snowed-in patients.

Under ArchCare, the agency will be known as ArchCare VNAB Home Care (VNAB is for Visiting Nurse Association of Brooklyn).

“Having the opportunity to sponsor a home care agency really filled a void for us,” La Rue said.

He added that Cardinal Dolan specifically directed ArchCare to expand its home- and community-based services and expand the number of those served within the archdiocese. With that in mind, ArchCare set a goal to serve 150 percent more individuals on a daily basis within a three-year period. “To date, we’re serving 7,000 members, participants or residents on any given day,” La Rue said.